Remote Maryland Credentialing & Enrollment Specialist

ElevateCalls; Manila; Remote; PHP 3,781,000 - 5,356,000; Full time

Job summary

Elevate Calls Inc. is seeking a Credentialing Specialist with Maryland healthcare credentialing experience to join a growing remote team.

You will oversee credentialing and enrollment for Maryland-based providers and ensure compliance with state and payer requirements. Key duties include managing credentialing and recredentialing, submitting enrollment forms to Medicaid and Medicare via PECOS, and maintaining provider data in CAQH, NPPES, and internal systems.

Qualifications

• Healthcare credentialing experience
• Maryland credentialing standards familiarity
• Proficiency with CAQH, PECOS, NPPES

Responsibilities

• Manage credentialing and recredentialing for Maryland-based providers.
• Ensure files comply with Maryland regulations and payer guidelines.
• Submit enrollment forms to commercial payers, Medicaid, and Medicare (PECOS).
• Maintain provider data in CAQH, NPPES, and internal systems.
• Track license and certification expirations and deadlines.
• Communicate with insurers, government agencies, and internal teams to resolve issues.
• Stay updated on Maryland payer requirements and healthcare regulations.
• Conduct background checks and verify credentials for provider profiles.

Job description

Elevate Calls Inc. is seeking a Credentialing Specialist with Maryland healthcare credentialing experience to join a growing remote team.

You will oversee credentialing and enrollment for Maryland-based providers and ensure compliance with state and payer requirements. Key duties include managing credentialing and recredentialing, submitting enrollment forms to Medicaid and Medicare via PECOS, and maintaining provider data in CAQH, NPPES, and internal systems.